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Medical Issues

May 14, 2013

Preventing the spread of MRSA, CRE and other hospital-acquired
infections(HAIs) is quickly becoming a top priority in skilled nursing
and long-term care facilities. Caregivers need to be ever vigilant to
ensure that hands are washed, gloves are worn, personal protective
equipment procedures are followed and a litany of other precautions are
taken to protect patients, their families, and themselves. In addition
to the human cost, nosocomial infections in the U.S. add approximately
$40,000 in medical costs per patient due to longer hospital stays,
readmission, and further treatment.¹

Residents living with diabetes have weakened immune systems that make
them more susceptible to MRSA and other antibiotic-resistant
infections. Those in skilled nursing and long-term care facilities are
especially vulnerable, as this population is prone to developing skin
wounds that easily spread bacteria. In fact, 85% of MRSA outbreaks occur
in healthcare facilities.

The CDC recommends that facilities pay particular atttention to
cross-contamination points--the surfaces touched by an infected patient
which become the main vectors for the spread of MRSA, C. diff, and VRE.
Studies have shown that a surprisingly high percentage of presumed-clean
blood pressure cuffs that are shared among patients [in our facilities]
house these organisms …² As a result, the CDC has issued guidelines …
recommending the use of single-patient blood pressure cuffs.³

May 13, 2013

Besides having penned this newspaper
column about disability since 2002, I'm also a licensed professional
counselor and national certified counselor.

Recently, the American Mental Health Counselors Association (AMHCA)
sent an email to its membership declaring May 6-12 as "Mental Health
Counseling Week" and urging all AMHCA members to "set aside time during
(the week) to participate in local activities to promote and reinforce
the importance of mental health."

So today I'm tossing in my two cents. A disproportional percentage of people with disabilities also have a mental illness.

Overall, America is becoming more "disabled" as its population skews
older and medical science becomes more skilled at preserving the lives
of people with medical issues. The number of people claiming disability
benefits is skyrocketing. The federal government generally determines a
person has a disability when that person has a significant impairment in
any major life function, such as walking, seeing or thinking.

That was before doctors at a Maryland hospital
repeatedly told Brook his throat pain was the result of acid reflux,
not cancer. The correct diagnosis was made by an astute resident who
found the tumor — the size of a peach pit — using a simple procedure
that the experienced head and neck surgeons who regularly examined
Brook never tried. Because the cancer had grown undetected for seven
months, Brook was forced to undergo surgery to remove his voice box, a
procedure that has left him speaking in a whisper. He believes that
might not have been necessary had the cancer been found earlier.

“I consider myself lucky to be alive,” said Brook, now 72, of the 2006 ordeal, which he described at a recent international conference on diagnostic mistakes held in Baltimore. A physician for 40 years, Brook said he was “really shocked” by his misdiagnosis.

May 03, 2013

Patti's comment: I have had personal experiences
like this, as have many of my clients, so be careful folks!

When you’re buying a non-refundable plane ticket, it can be very
tempting to fork over the few extra dollars to pay for travel insurance
so that you’ll be able to get your money back in the case of an
emergency like a medical crisis. But as easy as it is to click on that
box and sign up for the plan, the insurance companies don’t always make
it easy when it comes time to file a claim.

Take the example in today’s L.A. Times of a California woman
who had to cancel her plans to visit Washington, D.C., in December
after she began experiencing shortness of breath and her doctor advised
her not to fly. Luckily, she’d paid $29.33 for a travel insurance policy
so she’d be able to get her $451 airfare refunded.

Not exactly.

See, this particular travel insurance policy has an exception for
cancellations due to pre-existing medical conditions, and the insurer
eventually determined that the passenger’s cancellation fell under this
category.

April 14, 2013

The mis­use and abuse of pre­scrip­tion med­ica­tion is a grow­ing
con­cern. I remem­ber speak­ing with col­leagues 15–20 years ago as
reports about the non­med­ical use of stim­u­lant med­ica­tions used to
treat ADHD (non­med­ical use is defined as use by indi­vid­u­als
with­out a pre­scrip­tion) were first appear­ing in the media. At the
time, these were gen­er­ally thought to be iso­lated inci­dents that
were being over-dramatized in the press.

It
has become clear, how­ever, that this is not the case today and that
the non­med­ical use of ADHD meds, as well as mis­use by indi­vid­u­als
for whom med­ica­tion is pre­scribed, is an impor­tant prob­lem. At the link above
is a brief overview and sum­mary of research on these issues.

April 12, 2013

One given principle of the Americans With Disabilities Act provides
that employee medical information obtained from “medical examinations
and inquiries” must be treated as a confidential medical record. The
issue is what is an inquiry?

Consider these facts: an employee
failed to report to work. The employer sent the employee an email,
asking him what he was doing. The employee replied with an email stating
he had a severe migraine.

Shortly thereafter, the employee quit
his job. Future employers contacted the former employer and asked for a
reference. The former employer responded by saying that the ex-employee
had “medical conditions” involving migraines, but that this wasn’t an
issue in his job performance.

The Equal Employment Opportunity
Commission filed suit against the former employer, claiming that its
disclosure of the medical condition was a per se violation of the ADA.
The employer defended by arguing that its receipt of the employee’s
medical information, in the email the employee initiated, was not
obtained from a medical inquiry.

The court ruled for the employer.
It rejected the EEOC’s argument that any communication between an
employer and an employee, initiated by the employer, which results in
the disclosure of medical information is an “inquiry.”

April 10, 2013

You may have already read or heard about Steven Brill's excellent,
long article in Time magazine, called "Bitter Pill: Why Medical Bills
Are Killing Us." If you think it doesn't concern you, don't be so sure.

April 05, 2013

Studies published in Nature describe data
that seem to point to a link between sodium and the risk for developing
autoimmune diseases, such as multiple sclerosis.

The researchers found that people who ate fast food more than once a
week had a higher number of TH17 cells than people who did not eat fast
food. These TH17 cells usually help the body repair itself or fight
disease, but it seems like salt may cause them to multiply too fast, at
which point they attack the body's own tissues and cause autoimmune
disease.

Exposing the immune cells of mice to sodium caused the cells to
produce more TH17. When mice that were genetically engineered to develop
MS were fed a high-salt diet, their disease progressed rapidly.